Background: Sickle cell disease (SCD) is associated with an increased risk of medical complications during pregnancy and they constitute a very high-risk group with associated increased maternal and perinatal morbidity and mortality especially in a low resource setting. Objective: To determine the pregnancy outcomes among women with sickle cell disease delivered at Alex Ek

Background:Threatened miscarriage is the commonest complication of pregnancy and has been aBackground: Threatened miscarriage is the commonest complication of pregnancy and has been associated with adverse pregnancy outcomes. Therefore, the aim of this study is to determine the association between threatened miscarriage and adverse maternal and perinatal outcomes.Methods: This was a retrospective case-control study undertaken at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The study involved 228 women presenting with threatened miscarriage in the first trimester and 228 asymptomatic matched controls. The statistical analysis was done using Epi info version 7.1.5, March 2015 (CDC, Atlanta, Georgia, USA).Results: Women with threatened miscarriage were more likely to have preterm delivery (OR = 7.1, 95% CI = 3.51-14.32, P <0.0001), placenta praevia (OR = 2.4, 95% CI = 1.13 - 5.26, P = 0.03), placental abruption (OR = 3.6, 95% CI = 1.40 - 9.03, P = 0.01) and retained placenta (OR = 2.9, 95% CI = 1.18 - 6.97, P = 0.02). Similarly, women with first trimester threatened miscarriage were more likely to develop postpartum haemorrhage (OR = 2.4, 95%               CI = 1.17 - 5.06, P = 0.02). There was no significant differences in the stillbirth rate, Apgar scores at 5 minutes less than 7, admission into neonatal intensive care unit and early neonatal death. Threatened miscarriage was associated with intrauterine growth restriction (OR = 3.5, 95% CI = 1.77 - 6.88, P <0.0001) and low birth weight <2.kg                 (OR = 3.2, 95% CI = 1.33 - 7.69, P = 0.01).Conclusions: Women with threatened miscarriage in the first trimester are at increased risk of adverse pregnancy outcomes and the risk factors should be taken into consideration when deciding upon antenatal surveillance and management of their pregnancies.

Objective To determine the normal range of shock index (SI), blood pressure (BP), mean arterial pressure (MAP) and heart rate (HR) among postpartum women in a low‐resource setting. Methods In a prospective cohort study, vital signs were recorded 1 hour after delivery among postpartum women with normal blood loss who delivered in Abakaliki, Nigeria, from April to July 2019. Results Among 225 women, the median (95% reference range) was 120 (100–155.8), 70 (60–94), and 90 (66.5–116.6) mm Hg for systolic BP, diastolic BP, and MAP, respectively; 82 (65–102) bpm for HR; and 0.69 (0.48–0.89) for SI. The upper SI limit of 0.89 supported the current value of 0.9 as the upper limit; however, the lower SI limit of 0.48 corresponded to the current lower limit for a non‐obstetric population (0.5). The SI of more than half of the study women (n=126; 56.0%) was within the normal range for non‐obstetric women (0.5–0.7). Conclusion Although hemodynamic changes in pregnancy widen the SI range, 56.0% of women maintained SI within the non‐obstetric reference range. In low‐resource settings, the current normal obstetric SI range of 0.7–0.9 should be revised to 0.5–0.9 to accommodate this lower threshold.

Background: Preeclampsia is a pregnancy specific multisystem disease and it is associated with increased maternal and perinatal morbidity and mortality. Any factor(s) which could reliably predict the likelihood of serious complications would be very valuable in predicting the associated adverse outcome. Objective of this study compare maternal and fetal outcomes of preeclamptic patients with normotensive control in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.Method: This was a 4-year retrospective case-control study of the pregnancy outcomes among preeclamptic and normotensive women managed in our facility between 1st January 2012 and 31st December 2015. Data analysis was done using Epi Info software 7.2.1.Results: During the study period there were 6,585 deliveries among which 92 of the patients were managed for preeclampsia. This gives a prevalence of 1.4% or 14 per 1000 deliveries. There was no difference in the age and parity of the control. Most of the preeclamptic patients managed over the study period were unbooked for antenatal care in the facility (p value <0.0001). Preeclamptic patients were more likely to be delivered preterm (p value was <0.0001), and by caesarean section compared to the control. They were also more likely to have babies with low birth weights and poorer fetal outcomes. There was no difference in maternal mortality between both groups.Conclusion: Preeclampsia is associated with the unbooked status and poorer perinatal outcome compared with normotensive women. There is need to encourage women to book for antenatal care for prompt identification and management of these women.

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